Deck 15: Practical Pharmacotherapy of Drugs Used to Treat Psychiatric Disorders

Question 1

Alprazolam (Xanax)is contraindicated in a patient taking which medication?

A)lithium (Eskalith)
B)ketoconazole (Nizoral)
C)amoxicillin (Amoxil)
D)acyclovir (Zovirax)

Answer 1

ketoconazole (Nizoral)

Question 2

Which of the following drugs is used to manage both positive and negative mood symptoms of schizophrenia because of the low incidence of side effects and increased safety profile over clozapine (Clozaril)?

A)fluphenazine (Prolixin)
B)doxepin (Silenor)
C)venlafaxine (Effexor)
D)olanzapine (Zyprexa)

Answer 2

olanzapine (Zyprexa)

Question 3

When starting a patient on imipramine (Tofranil),how long should it take for the antidepressant clinical effects to appear?

A)24 hours
B)3 days
C)5 to 7 days
D)14 to 60 days

Answer 3

14 to 60 days

Question 4

Which selective SSRI is secreted in breast milk?

A)fluoxetine (Prozac)
B)paroxetine (Paxil)
C)citalopram (Celexa)
D)sertraline (Zoloft)

Question 5

Which benzodiazepine is metabolized in the liver and therefore should not be used in those with liver disease?

A)lorazepam (Ativan)
B)temazepam (Restoril)
C)midazolam (Versed)
D)oxazepam (Serax)

Question 6

Which of the following drugs can cause extrapyramidal side effects,such as akathisia,dystonia,and neuroleptic malignant syndrome?

A)fluoxetine (Prozac)
B)fluphenazine (Prolixin)
C)amitriptyline (Elavil)
D)bupropion (Wellbutrin)

Question 7

Tardive dyskinesia is a side effect of which drug?

A)trazodone (Desyrel)
B)chlorpromazine (Thorazine)
C)risperidone (Risperdal)
D)amitriptyline (Elavil)

Question 8

Diazepam has a fast onset,with peak effect occurring in:

A)30 to 60 minutes.
B)30 minutes to 2 hours.
C)1 to 2 hours.
D)6 hours.

Question 9

Sertraline (Zoloft)is usually dosed:

A)One capsule BID.
B)One capsule a.m.
C)One capsule p.m.
D)One or two capsules TID.

Question 10

Which drug is a tricyclic antidepressant that is preferred in the treatment of severely depressed patients who are anxious and agitated,specifically because of its sedating effect?

A)doxepin (Silenor)
B)protriptyline (Vivactil)
C)sertraline (Zoloft)
D)venlafaxine (Effexor)

Question 11

Although tricyclic antidepressants (TCAs)and selective SSRIs have about the same efficacy when treating depression,TCAs:

A)Take less time to reach steady state and show clinical effectiveness.
B)Take more time to reach steady state and show clinical effectiveness.
C)Inhibit reuptake of 5HT.
D)Inhibit reuptake of 5HT and dopamine.

Question 12

Patients taking nortriptyline and amitriptyline should be monitored for which of the following?

A)Hypertension
B)Confusion
C)Weight loss
D)Elevated liver enzymes

Question 13

Benzodiazepines are regulated by the Controlled Substances Act as which class of medication and thus have restrictions on their prescribing?

A)Class I
B)Class II
C)Class III
D)Class IV

Question 14

Which selective serotonin reuptake inhibitor (SSRI)is used in the treatment of obsessive-compulsive disorder and in treating depression that is resistant to other drugs?

A)fluoxetine (Prozac)
B)paroxetine (Paxil)
C)citalopram (Celexa)
D)sertraline (Zoloft)

Question 15

Although many SSRIs inhibit reuptake of serotonin at CNS neurons,this agent causes more serotonin and norepinephrine to be released.

A)trazodone (Desyrel)
B)bupropion (Wellbutrin)
C)venlafaxine (Effexor)
D)paroxetine (Paxil)

Question 16

Which drug is used in the treatment of depression but has also recently found favor as an agent in smoking cessation programs when combined with behavior modification?

A)sertraline (Zoloft)
B)fluoxetine (Prozac)
C)venlafaxine (Effexor)
D)bupropion (Wellbutrin)

Question 17

Which medication requires complete blood count monitoring due to the increased risk of aplastic anemia?

A)olanzapine (Zyprexa)
B)aripiprazole (Abilify)
C)carbamazepine (Tegretol)
D)duloxetine (Cymbalta)

Question 18

What is lithium?

A)Tertiary amine
B)Light alkaline metal,a monovalent cation similar to sodium and potassium
C)Natural substance that helps metabolize catecholamines
D)Chemical salt that is a norepinephrine agonists

Question 19

Which statement best describes the actions of gamma-aminobutyric acid (GABA)?

A)The major inhibitory neurotransmitter in the CNS
B)A substance that binds with a CNS receptor to excite a postsynaptic neuron
C)An unpleasant emotional state consisting of apprehension,fear,and feelings of danger
D)A natural substance commonly used to treat anxiety

Question 20

Trazodone (Desyrel)should be taken in divided doses because it can increase the concentration of which drug?

A)warfarin (Coumadin)
B)alprazolam (Xanax)
C)amitriptyline (Elavil)
D)amoxapine (Asendin)

Question 21

How much of a recommended adult dose of antipsychotics should be prescribed to an elderly patient?

A)One-eighth
B)One-fourth
C)One-half
D)100%

Question 22

Which drug has been used in the treatment of Tourette's syndrome?

A)aripiprazole (Abilify)
B)pimozide (Orap)
C)risperidone (Risperdal)
D)ziprasidone (Geodon)

Question 23

Benzodiazepines are classified as which schedule of drug?

A)Schedule II
B)Schedule III
C)Schedule IV
D)Schedule V

Question 24

Which option describes a U.S.Food and Drug Administration (FDA)safety category C drug?

A)Risk to the fetus cannot be ruled out;either studies in animals have revealed adverse effects on the fetus (teratogenic or embryocidal effects or other)and there are no controlled studies or studies in women and animals are not available.
B)There is no evidence of risk to the human fetus.
C)Controlled studies show no risk to the fetus.
D)There is positive evidence of risk to the fetus,but the benefits from use in pregnant women may be acceptable in certain clinical settings despite the risk.

Question 25

Which option best describes the mechanism of action of SSRIs?

A)Competitively block postsynaptic dopamine receptors
B)Block neuronal reuptake of norepinephrine and serotonin at the presynaptic terminals
C)Nonselectively inhibit the enzyme monoamine oxidase in its CNS storage sites
D)Selectively inhibit 5-HT neuronal reuptake at selected nerve terminals in the CNS

Question 26

Which drug is infrequently used to treat depression because safer,easier-to-dose,and more effective drugs are available?

A)fluphenazine (Prolixin)
B)fluoxetine (Prozac)
C)citalopram (Celexa)
D)sertraline (Zoloft)

Question 27

An estimated 5% of patients who have taken lithium for more than 1 year develop symptoms of which condition?

A)Hypothyroidism
B)Diabetes
C)Hyperthyroidism
D)Hyperlipidemia

Question 28

Which drug can relieve anxiety along with nicotine withdrawal symptoms?

A)haloperidol (Haldol)
B)mirtazapine (Remeron)
C)buspirone (Wellbutrin)
D)trazodone (Desyrel)

Question 29

When the federal government passed regulations that allowed children and adolescents to be given antidepressant drugs based on studies done in adults,it did so with the proviso that clinicians do what?

A)Start therapy using one-half the adult recommended dosages
B)Start therapy based on the child's body weight
C)Provide warnings about the increased risk of suicidal ideation
D)Never use TCAs in anyone younger than age 16

Question 30

Which mechanisms of action accounts for a large portion of side effects when taking TCAs?

A)Block neuronal reuptake of norepinephrine and serotonin at the presynaptic terminals
B)Block histamine-1 and alpha-adrenergic receptors
C)Increase norepinephrine reuptake
D)Increase serotonin receptor sensitivity

Question 31

How often should serum,urea,and electrolyte levels be taken for patients on lithium because of the low margin of safety between its effectiveness and its toxicity?

A)Once a week
B)Once a month
C)Every 3 months
D)Every 9 months

Question 32

The only SSRI approved by the FDA for the treatment of unipolar depression in adolescents is:

A)lithium.
B)quetiapine (Seroquel).
C)olanzapine (Zyprexa).
D)fluoxetine (Prozac).

Question 33

Which drug can be used to help treat neuroleptic malignant syndrome (NMS)?

A)dantrolene (Dantrium)
B)fluoxetine (Prozac)
C)perphenazine (Trialfon)
D)thioridazine (Mellaril)

Question 34

Which antidepressant is similar to benzodiazepines in that when it is used to treat depression,it is particularly effective for improving sleep because its side effects include drowsiness?

A)lithium (Eskalith)
B)bupropion (Wellbutrin)
C)trazodone (Desyrel)
D)doxepin (Sinequan)

Question 35

The common antidepressant fluoxetine is considered to be in what FDA safety category?

A)Category A
B)Category B
C)Category C
D)Category D

Question 36

In patients taking antipsychotics,tardive dyskinesia usually occurs in what timeframe?

A)After 1 week of use
B)After 1 month of use
C)After 4 months of use
D)After 6 months of use

Question 37

Which substance can prolong the half-life of lithium?

A)Sodium
B)Potassium
C)Vitamin C
D)Calcium

Question 38

Which side effect is common to MAOIs,TCAs,and SSRIs?

A)Weight gain
B)Arrhythmias
C)Nausea and vomiting
D)Polyuria

Question 39

Which option describes the mechanism of action of TCAs?

A)Competitively block postsynaptic dopamine receptors
B)Block neuronal reuptake of norepinephrine and serotonin at the presynaptic terminals
C)Nonselectively inhibit the enzyme monoamine oxidase in its CNS storage sites
D)Selectively inhibit 5-HT neuronal reuptake at selected nerve terminals in the CNS